Формирование новой модели здравоохранения: концептуальный подход и пилотная реализация
In the internal medicine wide spectrum the gastroenterology is one of the chapters, less enlightened by the scientific evidence. It does not mean that the practice of the grasntroenterology may ot be improved by the systematic use of the approaches of the evidence based medicine
In recent years, regional executive bodies and health aithorities have paid much attention towards chronic non-communicable diseases prevention and healthy lifestyle development among the population of the Russian North. Objective - to study the implementation of the regional state policy for chronic non-communicalble diseases prevention and healthy lifestyle promotion in the regions of the Russian North. It will allow to identify the best practices, innovative methods and mechanisms how to work with different segments of the population. It will be useful for further replication in order to improve population health in the northern territories as well as in other Russional regions. Material and methods: aithors used as the empirical basis for comparative analysis annial documents and reports on the organization of public health for 2015 of six regions: Yamalo-Nenets Aitonomous District, Sakha Yakutia, Arkhangelsk Oblast, Komi Republic, Krasnoyarsk Krai and the Murmansk region. Results& Conclisions: authors identified main directions for regional, local programs and initiatives' improving in order for better healthy lifestyle promotion and early non-comminicable diseases prevention in rural and remove areas of the North of Russia. There are a real need for strengthening the role of leading state regional medical organization, which coordinate work on chronic non-communicable diseases prevention and healthy lifestyle promotion, organazing Coordunation Councils for inter-agency cooperation, and organizing active participation of the population in all events under the framework of World and National Health Days and fight against diseases. Very important to use modern and interactive technologues for working with young people.
The paper addresses the issues of organization of medical care in the Russian Federation and explores the case of specialized medical care restructuring. The new approach towards specialized medical care povision is suggested as an alternative to the prevalent understanding of the restructuring such as reduction of hospital beds, hospitals and their staff for financial reasons. The new approach includes (1) a four-level system of medical aid, (2) the expansion of disease prevention, (3) the introduction of standardized approaches in routine work, (4) a thorough quality control at all levels of medical care.
The pilot project of the restructuring of urologic medical care started in 2010 in Voronezh region. The empirical data were provided by the Institute of Urology (Moscow) and Voronezh Regional Health Department.
The implimentation of a new approach revealed poor performance of the primary medical care provision. The outcomes of the pilot project were an increase in detecting diseases and in the availability of specialized outpatient and inpatient care. The overcoming of the previous system’s flaws caused the need to increase health care costs. However, the introduction of new organizational technologies, providing urological care, resulted in lower unit costs by 21.7% over four years.
Experience of the structural reform presented in the article shows that in cases where inefficiency of the health care system is associated not only with unreasonably high costs for treatment of diseases, but also with insufficient or delayed detectability of diseases, introduction of new approaches to the organization of health care does not lead to saving costs, but to increasing effectiveness and efficiency of health care provision.
This article is devoted to the methodological issues of the application of artificial intelligence techniques in preventive medicine. We showed a specific example of the neural network application allows not only to diagnose cardiovascular diseases, but also on a quantitative basis to predict their emergence and development in future periods of life. This allows you to select the optimal strategy for the prevention and treatment of patients based on their individual parameters. The article concluded: recommendations for the prevention and treatment of cardiac patients should be given strictly individually, taking into account physiological peculiarities of the organism of patients. If for some patients it is useful to give up Smoking, limit the consumption of sweets, take drugs, reduce blood pressure, etc., for other patients, these recommendations may cause harm. Our intelligent system helps to identify such non-standard patients and to avoid incorrect recommendations. The prototype of the proposed system laid out in the "Projects" section on the website www.PermAi.ru.
This prototype development explains the challenges encountered during the ISO/IEEE 11073 standard implementation process. The complexity of the standard and the consequent heavy requirements, which have not encouraged software engineers to adopt the standard. The developing complexity evaluation drives us to propose two possible implementation strategies that cover almost all possible use cases and eases handling the standard by non-expert users. The first one is focused on medical devices (MD) and proposes a low-memory and low-processor usage technique. It is based on message patterns that allow simple functions to generate ISO/IEEE 11073 messages and to process them easily. MD act as X73 agent. Second one is focused on more powerful device X73 manager, which do not have the MDs' memory and processor usage constraints. The protocol between Agent and Manager is point-to-point and we can distribute the functionality between devices.
Developed both implementation X73 Agent and Manager will cut developing time for applications based on ISO/EEE 11073.
The article is devoted to the study of the authoritarianism prevalent in the mass consciousness of Russians. The article describes a new approach to the consideration of the authoritarian syndrome as the effects of the cultural trauma as a result of political and socio-cultural transformation of society. The article shows the dynamics of the symptoms of the authoritarianism, which appear in the mass consciousness of Russians from 1993 to 2011. This paper proposes a package of measures aimed at reducing the level of the authoritarianism in Russian society.
This work looks at a model of spatial election competition with two candidates who can spend effort in order to increase their popularity through advertisement. It is shown that under certain condition the political programs of the candidates will be different. The work derives the comparative statics of equilibrium policy platform and campaign spending with respect the distribution of voter policy preferences and the proportionality of the electoral system. In particular, it is whown that the equilibrium does not exist if the policy preferences are distributed over too narrow an interval.
The article examines "regulatory requirements" as a subject of state control over business in Russia. The author deliberately does not use the term "the rule of law". The article states that a set of requirements for business is wider than the legislative regulation.
First, the article analyzes the regulatory nature of the requirements, especially in the technical field. The requirements are considered in relation to the rule of law. The article explores approaches to the definition of regulatory requirements in Russian legal science. The author analyzes legislation definitions for a set of requirements for business. The author concludes that regulatory requirements are not always identical to the rule of law. Regulatory requirements are a set of obligatory requirements for entrepreneurs’ economic activity. Validation failure leads to negative consequences.
Second, the article analyzes the problems of the regulatory requirements in practice. Lack of information about the requirements, their irrelevance and inconsistency are problems of the regulatory requirements in Russia.
Many requirements regulating economic activity are not compatible with the current development level of science and technology. The problems are analyzed on the basis of the Russian judicial practice and annual monitoring reports by Higher School of Economics.
Finally, the author provides an approach to the possible solution of the regulatory requirements’ problem. The author proposes to create a nationwide Internet portal about regulatory requirements. The portal should contain full information about all regulatory requirements. The author recommends extending moratorium on the use of the requirements adopted by the bodies and organizations of the former USSR government.